Deceased donation in Asia: Challenges and opportunities

Lo, Chung‐Mau

doi:10.1002/lt.23545

Cited by 58 publications

(40 citation statements)

References 11 publications

(10 reference statements)

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“…However, the beneficial impact of LDLTs has been well documented with acceptable short-term and long-term survival outcomes and a significantly reduced waiting list mortality of recipients. 1,29,30 Also, the acceptable thresholds for LD risk have been established through trial and error over several decades. In our present study, none of the donors were suitable for SG ALDLT in terms of donor safety and/or expected recipient's poor outcome.…”

Section: Discussionmentioning

confidence: 99%

Dual-graft Adult Living Donor Liver Transplantation

Song

Lee²,

Moon³

et al. 2017

Annals of Surgery

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Section: Discussionmentioning

confidence: 99%

Dual-graft Adult Living Donor Liver Transplantation

Song

Lee²,

Moon³

et al. 2017

Annals of Surgery

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“…Higher per capita income in these developing countries is the main reason for the rising trend of organ donation and transplantation. However, most of these countries are faced with the disproportionate rate of available donor organs to the current demand (10, 15, 16). According to our findings, the number of cases referred to organ transplant centers (i.e., patients with brain death per year) was not significantly different during the course of the study.…”

Section: Discussionmentioning

confidence: 99%

Process and barriers to organ donation and causes of brain death in northeast of Iran

Bahrami¹,

Khaleghi²,

Vakilzadeh³

et al. 2017

Electron physician

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IntroductionOrgan transplantation is the treatment of choice for some diseases. However, the need for cadaveric organ donation has either plateaued or is on a decreasing trend in some countries, especially in developed ones. In this study, we aimed to identify the barriers to organ donation in brain dead patients, who were referred to the organ procurement organizations (OPO) in northeast Iran.MethodsIn this cross-sectional study during 2006 to 2013, data were collected from medical records of brain dead patients. Demographic information, cause of brain death, the process of obtaining informed consent, and the reasons for declining organ donation were obtained from the OPO records. The data were analyzed using chi-square test by SPSS 13 software.ResultsOf 1034 brain dead patients, 751 cases (72.6%) were eligible for organ donation, and, ultimately, 344 cases underwent organ donation. The rate of organ donation increased during the course of the study; medical and legal reasons as well as family refusal to authorize donation were the main barriers to the process.ConclusionBased on the pattern of mortality, the need for living donors in developing countries, such as Iran and other countries in the Mediterranean region, can be reduced by improving the quality of healthcare, efficient identification of brain death, and obtaining consent with appropriate strategies.

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“…[13] Borrowing from medical anthropology works done on Japan [14,15], scholars have speculated that in contrast to the body-soul dichotomy and individual autonomy valued in the West, the integrated life view in Buddhist and folk beliefs, and the Confucian social structure built upon interpersonal relationships deter the Chinese people from accepting brain death [4]. However, little empirical research has been done to test this hypothesis.…”

Section: Introductionmentioning

confidence: 99%

Acceptance in Theory but not Practice – Chinese Medical Providers’ Perception of Brain Death

Yang

Cheng

et al. 2015

Neuroethics

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Background The brain death standard allowing a declaration of death based on neurological criteria is legally endorsed and routinely practiced in the West but not in Asia. In China, attempts to legalize the brain death standard have occurred several times without success. Cultural, religious, and philosophical factors have been proposed to explain this difference, but there is a lack of empirical studies to support this hypothesis. Methods 476 medical providers (72 attending physicians, 84 residents, 210 medical students, 110 nurses) from three academic hospitals in Hunan, China, completed a selfadministered survey including a 12question brain death clinical knowledge assessment and hypothetical vignettes describing brain dead patients.Results The response rate was 95.2 %. Almost all of the providers had heard of the term "brain death." More than half have encountered presumed brain dead patients. Two-thirds accepted brain death as an ethical standard to determine human death. The mean knowledge score was 8.50±1.83 out of 12. When given the description of a brain dead patient, 50.7 % considered the patient dead, 51.9 % would withdraw life support, and 40.6 % would allow organ procurement. Both provider and patient characteristics contributed to the providers' decisions. Ethical acceptance was the most important independent predictor for brain death acknowledgement, followed by high knowledge scores, and the belief that the soul lives in the brain. Religious faith and associated beliefs did not have a significant effect. Conclusions Notwithstanding scarce official accounts, recognition of the brain death standard is not uncommon in China. Chinese medical providers can adequately define the medical characteristics of brain death and accept it in theory, but hesitate to apply it to practice in the vignettes. Legalization is paramount in providing the protection providers need to comfortably declare brain death. However the medical decision-making surrounding brain death is complex and the provider's past experiences and emotions may also influence the process.

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Deceased donation in Asia: Challenges and opportunities

Cited by 58 publications

References 11 publications

Dual-graft Adult Living Donor Liver Transplantation

Dual-graft Adult Living Donor Liver Transplantation

Process and barriers to organ donation and causes of brain death in northeast of Iran

Acceptance in Theory but not Practice – Chinese Medical Providers’ Perception of Brain Death

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